BACKGROUND：In Shenzhen, the Emergency Medical Service （EMS） system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS.BACK...BACKGROUND：In Shenzhen, the Emergency Medical Service （EMS） system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS.BACKGROUND：In this retrospective quantitative descriptive study, the data from the Shenzhen 120 EMS registry in 2011 were analyzed.RESULTS：Shenzhen 120 EMS center is a communication command center. When the number of 120 are dialed, it is forwarded to the closest appropriate hospital for ambulance dispatch. In 2011, the Shenzhen 120 EMS center received 153 160 ambulance calls, with an average of 420 calls per day. Calling emergency services was mainly due to traffic accidents. Trauma and other acute diseases constituted a majority of ambulance transports. The adult patients aged 15-60 years are the principal users of EMS. There are no recognized ＇paramedic＇ doctors and nurses. The pre-hospital emergency service is under the operation of emergency departments of hospitals. Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in posttrauma management. Moreover, specialized pre-hospital training, financial support, and public health education on proper use of EMS should be emphasized.CONCLUSION：The Shenzhen 120 EMS center has its own epidemiology characteristics. Traumatic injury and traffic accident are the main reasons for calling ambulance service. In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS.展开更多
Objective: To determine the amount and type of changes in the Emergency Department, in order to hasten treatment and disposition process of patients in the Emergency Department to expedite by eliminating or minimizing...Objective: To determine the amount and type of changes in the Emergency Department, in order to hasten treatment and disposition process of patients in the Emergency Department to expedite by eliminating or minimizing such changes that decreases the cost of treatment and drug resistanceMethods: In this study, 1005 patients' file admitted to emergency department of Rasool Akram Hospital were reviewed to see at least two different health services or two shifts of one service with written orders.Results: In total, the rate of drug changes studied cases was obtained as 5.47%. The largest pharmaceutical group in which the changes were developed was antibiotic (2.8% from all cases and 50% of total drug changes). Among the various health services, the internal service had imposed the most changes (67.3% of total drug changes).Conclusions: Considering that after the removal of trauma patients, the frequency of drug changes had been 11.47%, then it should be noted that the frequency was high and it was not desirable. The greatest change has been operated by internal services due to the fact that most treatments in this department was carried out by drugs.展开更多
Background: In radiological emergencies with radionuclide incorporation, decorporation treatment is particularly effective if started early. Treating all people potentially contaminated("urgent treatment") m...Background: In radiological emergencies with radionuclide incorporation, decorporation treatment is particularly effective if started early. Treating all people potentially contaminated("urgent treatment") may require large antidote stockpiles. An efficacious way to reduce antidote requirements is by using radioactivity screening equipment. We analyzed the suitability of such equipment for triage purposes and determined the most efficient mix of screening units and antidote daily doses.Methods: The committed effective doses corresponding to activities within the detection limits of monitoring portals and mobile whole-body counters were used to assess their usefulness as triage tools. To determine the optimal resource mix, we departed from a large-scale scenario(60,000 victims) and based on purchase prices of antidotes and screening equipment in Germany, we calculated efficiencies of different combinations of medical countermeasure resources by data envelopment analysis. Cost-effectiveness was expressed as the costs per life year saved and compared to risk reduction opportunities in other sectors of society as well as the values of a statistical life.Results: Monitoring portals are adequate instruments for a sensitive triage after cesium-137 exposure with a high screening throughput. For the detection of americium-241 whole-body counters with a lower daily screening capacity per unit are needed. Assuming that 1% of the potentially contaminated patients actually need decorporation treatment, an efficient resource mix includes 6 monitoring portals and 25 mobile whole-body counters. The optimum mix depends on price discounts and in particular the fraction of victims actually needing treatment. The costeffectiveness of preparedness for a "dirty bomb" attack is less than for common health care, but costs for a life year saved are less than for many risk-reduction interventions in the environmental sector.Conclusion: To achieve economic efficiency a high daily screening capacity is of major importance to substantially decrease the required amount of antidote doses. Among the determinants of the number of equipment units needed, the fraction of the potentially contaminated victims that actually needs treatment is the most difficult to assess. Judging cost-effectiveness of the preparedness for "dirty bomb" attacks is an issue of principle that must be dealt with by political leaders.展开更多
During the period of COVID-19,the medical waste disposal capacity is seriously inadequate.The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incinerati...During the period of COVID-19,the medical waste disposal capacity is seriously inadequate.The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incineration system.Under the conditions of optimizing the technological process,improving the supporting facilities,and controlling the co-processing ratio,the municipal solid waste incinerator(grate furnace)co-processing medical waste is feasible.Some suggested guidelines for emergency treatment of medical waste from COVID-19 have been provided by China.展开更多
Background:Osteomyelitis of the spine is a serious condition that has been increasing with the intravenous drug pandemic and aging population.Multiple different organisms can cause osteomyelitis and mainstay of treatm...Background:Osteomyelitis of the spine is a serious condition that has been increasing with the intravenous drug pandemic and aging population.Multiple different organisms can cause osteomyelitis and mainstay of treatment is early recognition and antibiotics.The course can sometimes be indolent leading to delayed presentations.Once suspected,comprehensive workup and initiation of management should be employed.In rare circumstances,surgical evacuation or deformity correction is indicated.Continued antibiotic treatment should be considered post-operatively.Methods:Emerging treatment solutions are being developed to help target osteomyelitis in a more effective manner.In this review,we highlight the epidemiology and pathophysiology of spinal osteomyelitis.We overview the diagnostic workup and treatment options.Finally,we present new options that are currently being investigated and are on the near horizon.Conclusion:This review offers a user friendly resource for clinicians and researchers regarding osteomyelitis of the spine and will serve as a catalyst for further discovery.展开更多
目的:设计一种基于光学字符识别(optical character recognition,OCR)模型的医疗救治装备数据采集平台,以实现应急灾害救援条件下医疗数据的自动化采集。方法:该平台以医疗物联网“感知—网络—平台”架构为基础构建。首先,选取Raspberr...目的:设计一种基于光学字符识别(optical character recognition,OCR)模型的医疗救治装备数据采集平台,以实现应急灾害救援条件下医疗数据的自动化采集。方法:该平台以医疗物联网“感知—网络—平台”架构为基础构建。首先,选取Raspberry Pi 4B作为边缘节点,使用视频采集卡、摄像头、平板计算机等搭建硬件环境。其次,基于卷积循环神经网络(convolutional recurrent neural network,CRNN)优化OCR模型,通过软硬件协同方式实现医疗终端视频流处理与数据提取。最后,采用FineBI工具实现交互界面设计与数据库链接。结果:经实验验证,该平台的硬件环境可靠、稳定,优化后的OCR模型文本识别准确率提升,且采用该平台能够实现对医疗设备数据的快速、自动化采集。结论:采用该平台能够为医护人员提供全面、准确的医疗救治装备数据支撑,有利于提升医疗救治效率。展开更多
目的:分析2003-2023年重大疫情下医疗救治资源研究现状及热点,为医疗救治资源配置研究提供参考。方法:以中国知网、万方以及Web of Science核心合集为数据来源,运用CiteSpace软件对纳入文献进行发文量、作者、机构、关键词的可视化分析...目的:分析2003-2023年重大疫情下医疗救治资源研究现状及热点,为医疗救治资源配置研究提供参考。方法:以中国知网、万方以及Web of Science核心合集为数据来源,运用CiteSpace软件对纳入文献进行发文量、作者、机构、关键词的可视化分析。结果:共纳入相关文献1085篇,其中中文文献464篇、英文文献621篇,2003-2023年发文数量总体呈现上升趋势;研究热度随着突发传染病疫情的发生而增加;主要研究机构集中于高校和高校附属医院;国内外研究均未形成稳定的核心作者群。中英文文献研究热点为医疗资源优化配置策略、医疗资源管理与协调;英文文献研究热点还包括医疗资源需求预测、医疗资源分配原则等。结论:国内外研究存在差异,国外重大疫情下医疗救治资源研究形成了从配置原则、消耗风险到优化配置相对完整的研究体系,国内研究作者和机构数量较少、合作较为松散,尚未形成完整的研究体系。展开更多
目的分析高血压脑出血治疗中院前急救的应用效果。方法选取2019年8月至2020年8月在石阡县人民医院进行救治的100例高血压脑出血患者,根据急救方式的不同分为研究组与对照组,研究组采用院前急救,对照组未采取院前急救,每组各50例。比较...目的分析高血压脑出血治疗中院前急救的应用效果。方法选取2019年8月至2020年8月在石阡县人民医院进行救治的100例高血压脑出血患者,根据急救方式的不同分为研究组与对照组,研究组采用院前急救,对照组未采取院前急救,每组各50例。比较两组各项急救反应所需时间、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)以及临床疗效和并发症。结果研究组各项急救反应所需时间均显著短于对照组患者(P<0.001)。治疗后,两组患者NIHSS评分均降低,GCS评分均升高(P<0.001),且研究组NIHSS评分显著低于对照组(P<0.001),GCS评分显著高于对照组(P<0.001)。研究组临床有效率为90.00%,显著高于对照组的64.00%(P<0.05),差异有统计学意义。研究组并发症的发生率为4.00%,显著低于对照组的18.00%(P<0.05),差异有统计学意义。结论及时有效的院前急救护理干预,可缩短高血压脑出血患者急救反应时间,改善神经功能损伤程度,减少并发症的发生。展开更多
文摘BACKGROUND：In Shenzhen, the Emergency Medical Service （EMS） system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS.BACKGROUND：In this retrospective quantitative descriptive study, the data from the Shenzhen 120 EMS registry in 2011 were analyzed.RESULTS：Shenzhen 120 EMS center is a communication command center. When the number of 120 are dialed, it is forwarded to the closest appropriate hospital for ambulance dispatch. In 2011, the Shenzhen 120 EMS center received 153 160 ambulance calls, with an average of 420 calls per day. Calling emergency services was mainly due to traffic accidents. Trauma and other acute diseases constituted a majority of ambulance transports. The adult patients aged 15-60 years are the principal users of EMS. There are no recognized ＇paramedic＇ doctors and nurses. The pre-hospital emergency service is under the operation of emergency departments of hospitals. Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in posttrauma management. Moreover, specialized pre-hospital training, financial support, and public health education on proper use of EMS should be emphasized.CONCLUSION：The Shenzhen 120 EMS center has its own epidemiology characteristics. Traumatic injury and traffic accident are the main reasons for calling ambulance service. In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS.
文摘Objective: To determine the amount and type of changes in the Emergency Department, in order to hasten treatment and disposition process of patients in the Emergency Department to expedite by eliminating or minimizing such changes that decreases the cost of treatment and drug resistanceMethods: In this study, 1005 patients' file admitted to emergency department of Rasool Akram Hospital were reviewed to see at least two different health services or two shifts of one service with written orders.Results: In total, the rate of drug changes studied cases was obtained as 5.47%. The largest pharmaceutical group in which the changes were developed was antibiotic (2.8% from all cases and 50% of total drug changes). Among the various health services, the internal service had imposed the most changes (67.3% of total drug changes).Conclusions: Considering that after the removal of trauma patients, the frequency of drug changes had been 11.47%, then it should be noted that the frequency was high and it was not desirable. The greatest change has been operated by internal services due to the fact that most treatments in this department was carried out by drugs.
文摘Background: In radiological emergencies with radionuclide incorporation, decorporation treatment is particularly effective if started early. Treating all people potentially contaminated("urgent treatment") may require large antidote stockpiles. An efficacious way to reduce antidote requirements is by using radioactivity screening equipment. We analyzed the suitability of such equipment for triage purposes and determined the most efficient mix of screening units and antidote daily doses.Methods: The committed effective doses corresponding to activities within the detection limits of monitoring portals and mobile whole-body counters were used to assess their usefulness as triage tools. To determine the optimal resource mix, we departed from a large-scale scenario(60,000 victims) and based on purchase prices of antidotes and screening equipment in Germany, we calculated efficiencies of different combinations of medical countermeasure resources by data envelopment analysis. Cost-effectiveness was expressed as the costs per life year saved and compared to risk reduction opportunities in other sectors of society as well as the values of a statistical life.Results: Monitoring portals are adequate instruments for a sensitive triage after cesium-137 exposure with a high screening throughput. For the detection of americium-241 whole-body counters with a lower daily screening capacity per unit are needed. Assuming that 1% of the potentially contaminated patients actually need decorporation treatment, an efficient resource mix includes 6 monitoring portals and 25 mobile whole-body counters. The optimum mix depends on price discounts and in particular the fraction of victims actually needing treatment. The costeffectiveness of preparedness for a "dirty bomb" attack is less than for common health care, but costs for a life year saved are less than for many risk-reduction interventions in the environmental sector.Conclusion: To achieve economic efficiency a high daily screening capacity is of major importance to substantially decrease the required amount of antidote doses. Among the determinants of the number of equipment units needed, the fraction of the potentially contaminated victims that actually needs treatment is the most difficult to assess. Judging cost-effectiveness of the preparedness for "dirty bomb" attacks is an issue of principle that must be dealt with by political leaders.
基金supported by the National Natural Science Foundation of China(51621005)the Fundamental Research Funds for the Central Universities(2019FZA4010).
文摘During the period of COVID-19,the medical waste disposal capacity is seriously inadequate.The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incineration system.Under the conditions of optimizing the technological process,improving the supporting facilities,and controlling the co-processing ratio,the municipal solid waste incinerator(grate furnace)co-processing medical waste is feasible.Some suggested guidelines for emergency treatment of medical waste from COVID-19 have been provided by China.
文摘Background:Osteomyelitis of the spine is a serious condition that has been increasing with the intravenous drug pandemic and aging population.Multiple different organisms can cause osteomyelitis and mainstay of treatment is early recognition and antibiotics.The course can sometimes be indolent leading to delayed presentations.Once suspected,comprehensive workup and initiation of management should be employed.In rare circumstances,surgical evacuation or deformity correction is indicated.Continued antibiotic treatment should be considered post-operatively.Methods:Emerging treatment solutions are being developed to help target osteomyelitis in a more effective manner.In this review,we highlight the epidemiology and pathophysiology of spinal osteomyelitis.We overview the diagnostic workup and treatment options.Finally,we present new options that are currently being investigated and are on the near horizon.Conclusion:This review offers a user friendly resource for clinicians and researchers regarding osteomyelitis of the spine and will serve as a catalyst for further discovery.
文摘目的:设计一种基于光学字符识别(optical character recognition,OCR)模型的医疗救治装备数据采集平台,以实现应急灾害救援条件下医疗数据的自动化采集。方法:该平台以医疗物联网“感知—网络—平台”架构为基础构建。首先,选取Raspberry Pi 4B作为边缘节点,使用视频采集卡、摄像头、平板计算机等搭建硬件环境。其次,基于卷积循环神经网络(convolutional recurrent neural network,CRNN)优化OCR模型,通过软硬件协同方式实现医疗终端视频流处理与数据提取。最后,采用FineBI工具实现交互界面设计与数据库链接。结果:经实验验证,该平台的硬件环境可靠、稳定,优化后的OCR模型文本识别准确率提升,且采用该平台能够实现对医疗设备数据的快速、自动化采集。结论:采用该平台能够为医护人员提供全面、准确的医疗救治装备数据支撑,有利于提升医疗救治效率。
文摘目的:分析2003-2023年重大疫情下医疗救治资源研究现状及热点,为医疗救治资源配置研究提供参考。方法:以中国知网、万方以及Web of Science核心合集为数据来源,运用CiteSpace软件对纳入文献进行发文量、作者、机构、关键词的可视化分析。结果:共纳入相关文献1085篇,其中中文文献464篇、英文文献621篇,2003-2023年发文数量总体呈现上升趋势;研究热度随着突发传染病疫情的发生而增加;主要研究机构集中于高校和高校附属医院;国内外研究均未形成稳定的核心作者群。中英文文献研究热点为医疗资源优化配置策略、医疗资源管理与协调;英文文献研究热点还包括医疗资源需求预测、医疗资源分配原则等。结论:国内外研究存在差异,国外重大疫情下医疗救治资源研究形成了从配置原则、消耗风险到优化配置相对完整的研究体系,国内研究作者和机构数量较少、合作较为松散,尚未形成完整的研究体系。
文摘目的分析高血压脑出血治疗中院前急救的应用效果。方法选取2019年8月至2020年8月在石阡县人民医院进行救治的100例高血压脑出血患者,根据急救方式的不同分为研究组与对照组,研究组采用院前急救,对照组未采取院前急救,每组各50例。比较两组各项急救反应所需时间、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、格拉斯哥昏迷评分(Glasgow Coma Scale,GCS)以及临床疗效和并发症。结果研究组各项急救反应所需时间均显著短于对照组患者(P<0.001)。治疗后,两组患者NIHSS评分均降低,GCS评分均升高(P<0.001),且研究组NIHSS评分显著低于对照组(P<0.001),GCS评分显著高于对照组(P<0.001)。研究组临床有效率为90.00%,显著高于对照组的64.00%(P<0.05),差异有统计学意义。研究组并发症的发生率为4.00%,显著低于对照组的18.00%(P<0.05),差异有统计学意义。结论及时有效的院前急救护理干预,可缩短高血压脑出血患者急救反应时间,改善神经功能损伤程度,减少并发症的发生。
